What is the role of travel in the pathophysiology of thrombophlebitis?

Updated: Aug 31, 2020
  • Author: Padma Chitnavis, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Although the relationship between air travel and DVT was first recognized in 1954, [69] PE was noted to occur in Londoners confined to air raid shelters during World War II. In 1993, Lord and McGrath reported findings of 45 patients in whom venous thrombosis was related to travel (37 by air and 8 by road or rail). [70] Stationary travel for more than 4 hours increases the risk of venous thromboembolism 2-fold, even several weeks beyond the time of travel. [71] Clinical risk factors included previous thromboembolism (31%) and varicose veins (20%).

Lord reported that in 122 additional patients, thromboembolism was associated with prolonged travel. [72, 73] Hypercoagulable factors were isolated in 72% of patients who were tested. The most common factor was protein C resistance, which was found in 47% of patients.

At least one clinical or laboratory risk factor was present prior to travel in greater than 80% of patients who developed DVT after long-haul flights (>8 h), and SVT was diagnosed in 12% of this study group. [74] In most cases, the risk factors could be identified by medical history, without any laboratory testing. The most common risk factors were estrogen use, history of thrombosis, and the presence of factor V Leiden.


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